Handouts for Patients and Families (available on the accompanying CD) are included in the index and are indicated by CD rather than page numbers.

Transcription

1 index Handouts for Patients and Families (available on the accompanying CD) are included in the index and are indicated by CD rather than page numbers. AAC. See Augmentative communication system (AAC) AAC-RERC. See Rehabilitation Engineering Research Center on AAC (AAC-RERC) Academy of Neurologic Communication Disorders and Sciences (ANCDS), CD Acetylcholine, 79 Acid indigestion, CD Acquired Parkinson s disease, 69 ACTH (adrenocorticotropic hormone), 152 ADA (Americans With Disabilities Act), 154 Adrenocorticotropic hormone (ACTH), 152 Advanced health care directive, 177 Affective disorders. See also Depression with ALS, 8, 12, 30, 222 with multiple sclerosis, 150 AFO. See Ankle-foot orthosis (AFO) Akinesia, Alerting systems, 37 Alimentation, 221 Alphabet boards and alphabet supplementation, 37, 102, , 163, 221 ALS. See Amyotrophic lateral sclerosis (ALS) ALS Association of America (ALSA), 7, CD ALS Functional Rating Scale Revised, 4 ALS Health State Scale, 4 5 ALS Severity Scale, 24 29, 42, 43 44, Alternate motion rates, American Academy of Neurology, 6, 14, 17 American Parkinson Disease Association (APDA), CD American Speech-Language-Hearing Association (ASHA), CD Americans With Disabilities Act (ADA), 154 Amplifier, 221 Amyotrophic lateral sclerosis (ALS) age at onset of, x alternate motion rates with, 178 aphasia with, 20 aspiration management and, aspiration pneumonia with, 184 assessment of respiratory problems with, assessment of swallowing function in, assessment of, with ALS Severity Scale, 24 29, 42, 43 44, association on, CD benefits of early diagnosis, 6 cause of, 3 4 clinical stages of ambulatory function in, 9 cognitive changes with, x, compared with other motor neuron diseases, 1 2 definition, 1,

2 228 diagnosis, 5 6 eating habits and, emotional and psychosocial aspects of, 8, 12, 30 employment for individuals with, 40 exercise for, 7 8 frontal lobe syndrome and, 11 frontotemporal dementia (FTD)/ALS and, gender ratio in, 2 goals of rehabilitation for, 7 grief and depression with, 8 handout, CD hospice admission criteria for, 10 incidence of, 2 management of respiratory problems with, medications for, x, 6 7 muscle cramping and spasms in, 8 neurological changes with, x, 2 3 palliative care for, 9 10 patient autonomy and, 8 9 rate of speech changes in, 20, rate of swallowing disorders in, references on, rehabilitation medicine for, 7 10 respiratory problems with, saliva management and, signs and symptoms of, ix, x, 1, 2, 3, CD speech disorders with, x, 18 41, CD speech intelligibility related to other variables in, 20, speech treatment for, 29 41, CD surgery for swallowing disorders with, 52, survival data on, 2 swallowing disorders management for, swallowing disorders with, x, 42 54, CD typical course of, x, 4 5 weakness and, 3, 7, 8 ANCDS. See Academy of Neurologic Communication Disorders and Sciences (ANCDS) Ankle-foot orthosis (AFO), 221 Anticholinergic drugs, 79 APDA. See American Parkinson Disease Association (APDA) Aphasia, 20 Arizona Battery for Communication Disorders, 149 Artane, 79 Articulation definition, 221 with Parkinson s disease, 87, 88 ASHA. See American Speech-Language-Hearing Association (ASHA) Aspiration, 221, CD Aspiration management, Aspiration pneumonia, 184 Aspirator, 221 Assessment. See also Diagnosis; Interviews; Speech and swallowing examination of amyotrophic lateral sclerosis (ALS), 24 29, 42, 43 44, of conversation and interaction, , of dehydration, 51 Levels of Speech Usage Categorical Rating Scale, , of lower and upper extremity function in ALS, 27 29, of multiple sclerosis severity, of Parkinsonian dysarthria, 95, 99

3 of respiratory problems with ALS, 14 15, of speech disorders (dysarthria) in ALS, 25 26, 55 of speech disorders (dysarthria) in Multiple sclerosis, of speech function during clinical examination, 183, 187, of swallowing function during clinical examination, 183, , 191 of swallowing function in ALS, 26 27, 42, 43 44, 56, 184 of swallowing function in Huntington s disease, of swallowing function in multiple sclerosis, 166 of swallowing function in Parkinson s disease, Assistive technology. See also Augmentative communication system (AAC) with Huntington s disease, 138 with multiple sclerosis, 154 Assistive ventilatory, Associations and organizations, CD Ataxia, 153, 157, , 221, CD Athetosis, 71 Atrophy, 221, CD Audio recording of conversation, 199, , Auditory comprehension, 124 Augmentative communication system (AAC) alerting systems and, 37 alphabet boards and alphabet supplementation, 37, 102, , 163, 221 ALS Severity Scale and, 26 for amyotrophic lateral sclerosis (ALS), classification of functional capabilities for, for conversations, , , 206, 208 definition, 221, CD employment of individuals with ALS using, 40 funding of, handout, CD for Huntington s disease, 130 for multiple sclerosis, 163, CD multipurpose systems for, for Parkinson s disease, 102, CD patterns of system use, 39 portable writing systems and, 37 research center on, CD speech-language pathologists (SLPs) and, telephone communication and, 37 timing of AAC intervention, 36 Autonomy of patients, 8 9 Avonex, Basal ganglia, 70 71, 103, 122, 123, 221, CD Behavioral rate-control techniques, Betaseron, 152 Bilevel Positive Air Pressure (BiPAP), 16 BiPAP (Bilevel Positive Air Pressure), 16 Bolus, 221 Bradykinesia, 71 73, 221, CD Breathiness, 221 Bromocriptine, 78 Buccal/frontal/orbital muscles, Buccinators, , 187 Cachexia, 221 Calendars and memory aids, 132, 154 Catechol-O-methyltransferase (COMT), 79

4 230 Center for Neurologic Study Lability Scale, 12 Centers for Disease Control, 182 Central nervous system (CNS), 147, 150, 221 Charcot s disease. See Amyotrophic lateral sclerosis (ALS) Choking first aid for, 46, CD multiple sclerosis and, 166 Chorea, 71, 122, 124, 221 Clinical examination. See Speech and swallowing examination CNS. See Central nervous system (CNS) Cognitive problems with amyotrophic lateral sclerosis (ALS), x, frontal lobe syndrome and, 11 frontotemporal dementia (FTD)/ALS, with Huntington s disease, x, , with multiple sclerosis, x, , 154 with Parkinson s disease, x, 81 82, CD Cogwheel rigidity, 221 Communication. See Conversation and interaction Communication Independence for the Neurologically Impaired, 38 Computerized Speech Lab, COMT. See Catechol-O-methyltransferase (COMT) Comtan, 79 Contractures, 222 Conversation and interaction assessment of, , augmentative communication system (AAC) for, , , 206, 208 case examples, conversation starters for people with Huntington s disease, direct observation/analysis of, , , gaining attention for, 205 Huntington s disease and, 124 impact of dysarthria on, importance and organization of, interview for assessment of, , 207, Levels of Speech Usage Categorical Rating Scale, , management of, opportunities for, 198 perception of current problems with, 198 preferences and styles in, 198 problems with, , CD profiles of conversation partnership, recording of, 199, , references on, role of speech language pathologists in, showing understanding for, 205, 206 strategies for, 199 tips for, CD topic initiation and topic change for, 206 turn design for, 206 Copaxone, 152 Cough, 14, 17, 182 Counseling. See Psychological services and counseling Cuirass, 222 DAF. See Delayed auditory feedback (DAF) DBS. See Deep brain stimulation (DBS)

5 Decomposition, CD Deep brain stimulation (DBS), 79 80, 91 Degenerative diseases. See specific diseases Dehydration, 51. See also Liquid intake Delayed auditory feedback (DAF), 101, 222 Dementia definition, 222 frontotemporal dementia (FTD)/ALS, with Parkinson s disease, 81, 82 Deprenyl, Depression. See also Affective disorders with amyotrophic lateral sclerosis (ALS), 8 with Huntington s disease, 123 major depressive disorder (MDD), 150 with multiple sclerosis, 150 with Parkinson s disease, 80 81, 82 Diadochokinetic rates, 160, , 222 Diagnosis. See also Assessment; Speech and swallowing examination of amyotrophic lateral sclerosis (ALS), 5 6 of Huntington s disease, of multiple sclerosis, 150 of Parkinson s disease, 73 Dietary changes for gastroesophageal reflux disease (GERD), CD Huntington s disease and, 138 Parkinson s disease and, 109 for swallowing difficulties, 27, 47 48, CD Direct observation/analysis of conversation, , , Direct selection, 222 Disease-modifying therapy, 152 Dopamine, 222, CD Dopamine breakdown inhibition, Dopamine imitators, 78 Dopamine replacement, 78 Double swallow, 46 Drug management. See Medications Durable power of attorney for health care, 222 Dysarthria. See Speech disorders (dysarthria) Dyskinesia, 222 Dysmetria, 153 Dysphagia. See Swallowing disorders (dysphagia) Dysphagia Severity Rating Scale, 107, 108 Dystonia, CD Dystonic syndrome, Eating. See Dietary changes; Feeding; Swallowing disorders (dysphagia); Tube feeding EDSS (Expanded Disability Status Scale), 151 El Escorial criteria, 5 Eldepryl, Emergency procedures for choking, 46, CD Emotional lability, 12, 222. See also Affective disorders; Depression Employment compensatory techniques for individuals with multiple sclerosis in, 155 of individuals with ALS using AAC, 40 of individuals with multiple sclerosis, Entacapone, 79 Epiglottic sew-down procedures, 17, 54

6 232 Evaluation. See Assessment; Diagnosis; Speech and swallowing examination Exacerbations, CD Examination. See Speech and swallowing examination Exercise, 7 8. See also Rehabilitation Expanded Disability Status Scale (EDSS), 151, 165 Extrapyramidal system, 222 Extremity function. See Lower extremity function; Upper extremity function Eye-gaze systems, 41 Fasciculations, 222 Fatigue, 149, , 167 Feeding. See also Dietary changes; Swallowing disorders; Swallowing disorders management; Tube feeding alternative feeding for people with Huntington s disease, 138 calorie-dense foods, 47 control of eating rate and bite size, 138 definition, 222 early eating problems and ALS, 45, multiple sclerosis and, 165 normal eating habits and ALS, 45 Parkinson s disease and, 109 slowed eating, CD Festination, 222 Fibrillations, 222 First aid for choking, 46, CD Flaccid dysarthria, 223 Flaccidity, 223, CD Food. See Dietary changes; Feeding; Swallowing disorders Forced vital capacity (FVC), 14 15, 44, 182 Frontal lobe syndrome, 11 Frontotemporal dementia (FTD)/ALS, FTD. See Frontotemporal dementia (FTD)/ALS Functional status, FVC. See Forced vital capacity (FVC) GABA (gamma-aminobutyric acid), 122 Gag reflex, 223 Gamma-aminobutyric acid (GABA), 122 Gastroesophageal reflux disease (GERD), CD Gastrostomy, 223 GERD. See Gastroesophageal reflux disease (GERD) Glatiramer, 152 Grief. See Depression Harshness, 223 HDSA. See Huntington s Disease Society of America (HDSA) Heartburn, CD Heat sensitivity, 150 Heimlich maneuver, CD Hemiballismus, 71 Hoarseness, 223 Hoehn and Yahr Functional Rating Scale for Parkinson s disease, Hospice admission for ALS, 10 Huntington s disease age at onset of, x alphabet boards for people with, alternative feeding for people with, 138 assistive devices for people with, 138 association on, CD

7 augmentative communication system (AAC) for, 130 calendars and memory aids for people with, 132 characteristics of generally, ix clinical variants of, 122 cognitive problems with, x, , conversation starters for people with, definition, 121, 223 diagnosis, dietary changes for, 138 emotional disturbances with, 123 handout, CD hereditary nature of, 121, 125, 126 incidence of, 121 making choices for people with, 132 management of mild dysarthria and cognitive changes with, management of moderate dysarthria and cognitive changes with, management of severe dysarthria with, 129, measurement of functional progression of, 125 medical management of, 126 medications for, x motor disturbances with, natural speech with supportive partners, 131 neurological changes with, x, postural and positional changes for people with, references on, remotivation therapy for people with, 134 respiratory chorea with, 124 signs and symptoms of, x, 121, , CD speech characteristics associated with, speech disorders with, x, 124, 126, , CD speech treatment for, , CD supervision to control eating rate and bite size for people with, 138 swallowing characteristics associated with, 135, 136 swallowing disorders management for, swallowing disorders with, x, , CD yes/no system for people with, , 139 Huntington s Disease Society of America (HDSA), CD Hyperkinetic dysarthria, 86, 127, 223 Hypernasality, 223 Hypokinetic dysarthria, 86, 223 Hypotonia, ICF. See International Classification of Functioning, Disability and Health (ICF) Idiopathic Parkinson s disease, 69 Immunomodulatory agents, 152 Incidence, definition of, 223 Intention tremor, 147, 153, 155 Interaction. See Conversation and interaction Interferon beta-1a, 152 Interferon beta-1b, 152 International Classification of Functioning, Disability and Health (ICF), 130 Interviews. See also Assessment for assessment of conversation, , 207, for assessment of Parkinsonian dysarthria, 95 for speech assessment in multiple sclerosis, Swallowing Disorders Interview Worksheet, 191 for swallowing evaluation in Huntington s disease, 136 for swallowing evaluation in Parkinson s disease, 106

8 234 Jobs. See Employment Juvenile Huntington s disease, 122 KayPENTAX, 162 Kennedy disease, 1, 2 Language deficits. See also Speech disorders (dysarthria) with Huntington s disease, management of, with Huntington s disease, with multiple sclerosis, 149 with Parkinson s disease, 82 Laryngeal penetration, 223 Laryngectomy, 17, 54 Laryngotracheal separation, 17 Lee Silverman Voice Treatment (LSVT), 80, Lenticuar nucleus, 70 Lentiform nucleus, 70 Levels of Speech Usage Categorical Rating Scale, , Levodopa, 78, 79, 83, 103, 223 Lips, examination of, , 186 Liquid intake assessment and treatment of dehydration, 51 maintenance of, 46, 47 swallowing disorders and, 46, 47 48, CD taste, temperature, texture sensations of liquids, washing foods down with liquids, 47 Living will, 177, 223 Lou Gehrig s disease. See Amyotrophic lateral sclerosis (ALS) Lower extremity function assessment of, with ALS Severity Scale, 27 29, 57 definition, 223 Lower motor neurons, 223, CD LSVT. See Lee Silverman Voice Treatment (LSVT) Magnetic resonance imaging (MRI), 5, , 150 Major depressive disorder (MDD). See Depression MAO. See Monoamine oxidase (MAO) Mastication muscles, , 187 Mayo Clinic, 69, 78 MDA. See Muscular Dystrophy Association (MDA) MDD (major depressive disorder). See Depression Mechanical insufflation/exsufflation (MIE), 17 Medical history, , 176, 185 Medical management. See also Medications; Speech and swallowing examination; Surgery of Huntington s disease, 126 of Parkinson s disease, 77 80, 81 Medicare, Medications for amyotrophic lateral sclerosis (ALS), x, 6 7 disease-modifying therapy with, 152 for Huntington s disease, x for multiple sclerosis, x, 152 for Parkinson s disease, x, 77 79, 83, for saliva management, for speech disorders (dysarthria), for swallowing disorders (dysphagia), 107, 109 Memory aids and calendars, 132, 154 Memory problems. See Cognitive problems

9 MIE. See Mechanical insufflation/exsufflation (MIE) Mirapex, 78 Mitoxantrone, 152 MNDs. See Amyotrophic lateral sclerosis (ALS); Motor neuron diseases (MNDs) Monoamine oxidase (MAO), 78 Monoamine oxidase-b, 78 Motor disturbances with Huntington s disease, with multiple sclerosis, 147, Motor neuron diseases (MNDs), 1 2. See also Amyotrophic lateral sclerosis (ALS) Motor neurons, CD MRI (magnetic resonance imaging), 5, , 150 MSA. See Multiple system atrophy (MSA) Multiple sclerosis affective disorders with, 150 age at onset of, x, 146, 151 alphabet board supplementation for, 163 associations on, CD ataxia and, 153, 157, , CD characteristics of generally, ix choking with, 166 cognitive changes with, x, , 154 definition, 145, 224 diagnosis, 150 early stages of, employment and, epidemiology of, 146 fatigue with, 149, , 167 functional status of, handout, CD heat sensitivity with, 150 late stages of, 167 magnetic resonance imaging (MRI) and, , 150 medications for, x, 152 mild dysarthria with, moderate dysarthria with, 161, motor symptoms of, 147, neurological changes with, x, 145 paced speech for, primary progressive MS, 151 prognosis of, progression of changing function in, x, progressive-relapsing MS, 151 references on, rehabilitation for, relapsing-remitting MS, 149, 151 respiratory pattern stabilization program for, 162 respiratory patterning for, 163 risk factors for, 146 secondary progressive MS, 151 sensory symptoms of, 148, 155 severe dysarthria with, 161, signs and symptoms of, x, , 153, CD sites of central nervous system (CNS) lesions and impairment in, 147, 150 spasticity with, 147, 153, , 162 speech assessment issues for, speech characteristics associated with, 156 speech disorders with, x, , CD 235

10 236 speech treatment for, , CD swallowing difficulty management for, swallowing disorders with, x, , CD visual-motor problems with, vocabulary selection for, 164 Multiple system atrophy (MSA), 69, 73 74, 82, 86 Muscle cramping and spasms, 8 Muscular Dystrophy Association (MDA), CD Naming, 124 Nasal emission, 224 Nasogastric tube, 224 Natalizumab, 152 National Institute of Neurological Disorders and Stroke (NINDS), 7, CD National Multiple Sclerosis Society, 152, CD National Parkinson Foundation (NPF), CD NINDS. See National Institute of Neurological Disorders and Stroke (NINDS) NIV. See Noninvasive ventilation (NIV) Noninvasive ventilation (NIV), Normal eating habits, 45 Normal speech production, 31 32, CD Normal swallowing, CD Nothing by mouth. See NPO (nothing by mouth) Novantrone, 152 NPO (nothing by mouth) ALS Severity Scale and, 27 definition, 224 dysphagia and, 49 Observation/analysis of conversation, , , Occupational therapy, 81 Oculogyric crisis, 224 Olivopontocerebellar atrophy (OPCA), 74 On-off effect, 224 OPCA. See Olivopontocerebellar atrophy (OPCA) Organizations and associations, CD Paced speech, Pacing board, 102 Palatal lift prosthesis, 35, 224 Palate, , 187 Palilalia, 102, 224 Palliative care, 9 10 Pallidotomy, 79, 91 Paralysis agitans, 224 Parkinson Alliance, CD Parkinson plus syndromes, 69, 73 75, 86 Parkinson s disease age at onset of, x associations on, CD behavioral intervention (speech treatment) for, characteristics of generally, ix cognitive problems with, x, 81 82, CD compared with Parkinson plus syndromes, 69, 73 75, 86 compared with progressive supranuclear palsy (PSP), 69, 74 75, 86, , 224 definition, 69, 224 depression with, 80 81, 82

11 diagnosis, 73 feeding and dietary modifications for, 109 handout, CD Hoehn and Yahr Functional Rating Scale for, idiopathic Parkinson s disease, 69 incidence of, 69 language deficits with, 82 medical management of, medications for, x, 77 79, 83 natural course of, x neurological changes with, x, problems associated with, progression of dysarthria with, rate of progression of, references on, rehabilitation for, 80, 81 respiratory problems with, 82 83, 86 87, 97 secondary or acquired Parkinson s disease, 69 sensitivity of clinical signs of, 73 signs and symptoms of, x, 71 73, CD specificity of clinical signs of, 73, speech characteristics associated with, speech disorders with, x, , CD speech scale for, 90 speech treatment for, , CD surgery for, 79 80, 91 swallowing disorders management for, swallowing disorders with, x, , CD Unified Parkinson s Disease Rating Scale (UPDRS), 76, 77 Parkinson s Disease Foundation (PDF), 78, CD Parlodel, 78 Patient autonomy. See Autonomy of patients Patient s history, , 185 PBP. See Progressive bulbar palsy (PBP) PDF. See Parkinson s Disease Foundation (PDF) Peak expiratory cough flow (PECF), 14, 17 PECF. See Peak expiratory cough flow (PECF) PEG. See Percutaneous endoscopic gastrostomy (PEG) Percutaneous endoscopic gastrostomy (PEG), 14, 44, 48, 109, 224 Peripheral nervous system, 224 Pharmacological intervention. See Medications Pharyngeal constrictors, , 187 Phonation with amyotrophic lateral sclerosis (ALS), 181 definition, 224 with Parkinson s disease, 87, sustained phonation measure, 160 Phonatory instability, 224 Physical examination. See Speech and swallowing examination Physical therapy, 81 PLS. See Primary lateral sclerosis (PLS) PMA. See Primary progressive muscular (spinal) atrophy (PMA) Portable writing systems, 37 Postural instability, Pramipexole, 78 Prevalence, definition of, 224 Primary lateral sclerosis (PLS), 2 237

12 238 Primary progressive muscular (spinal) atrophy (PMA), 2 Procedural memory, 224 Progressive bulbar palsy (PBP), 2 Progressive supranuclear palsy (PSP), 69, 74 75, 86, , 224 PSP. See Progressive supranuclear palsy (PSP) Psychological services and counseling, 81. See also Affective disorders Pulmonary function tests, 15, 182, 224 Randomly selected sentences, 160 Rate-control techniques for Parkinsonian dysarthria, Rating scales Dysphagia Severity Rating Scale, 107, 108 Levels of Speech Usage Categorical Rating Scale, , for Parkinson s disease, 75 77, 99 for speech characteristics in Parkinson s disease, 99 Swallowing Performance Scale, 166 Reading of a standard passage, 160 Reading of randomly selected sentences, 160 Rebif, 152 Recording of conversation, 199, , Rehabilitation for amyotrophic lateral sclerosis (ALS), 7 10 exercise and, 7 8 goals of, 7 for multiple sclerosis, palliative care and, 9 10 for Parkinson s disease, 80, 81 patient autonomy and, 8 9 Rehabilitation Engineering Research Center on AAC (AAC-RERC), CD Remissions, CD Remotivation therapy, 134 Requip, 78 Respiration, 224. See also Respiratory problems Respiratory pattern stabilization program, 162 Respiratory patterning, 163 Respiratory problems with amyotrophic lateral sclerosis (ALS), 12 17, assessment of, 14 15, assistive ventilatory, examination of respiratory muscles, , 187 management of, with multiple sclerosis, with Parkinson s disease, 82 83, 86 87, 97 respiratory chorea with Huntington s disease, 124 speech production and, 86 87, 97 swallowing disorders and, Respiratory pump muscles, Respiratory valve muscles, 182 Respirometer, 182, 224 Resting tremor, CD, 71 72, 224 Rigid syndrome, 71 Rigidity definition, 225 with Huntington s disease, 122 with Parkinson s disease, 71 73, CD Riluzole, 6 Ropinirole, 78

13 Saliva management, 49 52, CD Scanning speech, 156 Secondary or acquired Parkinson s disease, 69 Selegiline, Sensitivity of clinical signs of Parkinson s disease, 73 Sensory symptoms of multiple sclerosis, 148, 155 Shy-Drager syndrome, 74, 86 SLPs. See Speech language pathologists (SLPs) SND. See Striatonigral degeneration (SND) Social interaction. See Conversation and interaction Spastic dysarthria, 86, 225 Spasticity with amyotrophic lateral sclerosis (ALS), CD definition, 225, CD with multiple sclerosis, 147, 153, , 162 Specificity of clinical signs of Parkinson s disease, 73 Speech and swallowing examination of buccal/frontal/orbital muscles, sternocleidomastoid/trapezius muscles, and vocal folds, current health care management, , 186 diadochokinetic rates, 160, , 222 form for, for Huntington s disease, 136 Levels of Speech Usage Categorical Rating Scale, , medical history, 176, 185 for multiple sclerosis, 160 of palate, muscles of mastication, pharyngeal constrictors, and buccinators, , 187 for Parkinson s disease, 95, 107 patient s history, , 185 physical examination, , reading of a standard passage, 160 reading of randomly selected sentences, 160 references on, of respiratory muscles, , 187 speech function assessment, 183, 187, sustained phonation, 160 Swallowing Disorders Interview Worksheet, 191 swallowing function assessment, , , 191 of tongue and lips, , 186 Speech disorders (dysarthria). See also Conversation and interaction; Language deficits; Speech and swallowing examination; Speech production; Speech treatment with amyotrophic lateral sclerosis (ALS), x, 18 41, CD articulation and, 87, 88 assessment of, in clinical examination, 183, 187, assessment of Parkinsonian dysarthria, 95, 99 assessment of, with ALS Severity Scale, 25 26, 55 assessment of, with multiple sclerosis, ataxia and, 153, 157, , CD compensation strategies for, CD definition of dysarthria, 222, CD handout, CD with Huntington s disease, x, 124, 126, , CD impact of, on conversations, medications for, mild dysarthria and cognitive change with Huntington s disease, mild dysarthria with multiple sclerosis, mild Parkinsonian dysarthria, moderate dysarthria and cognitive change with Huntington s disease,

14 240 moderate dysarthria with multiple sclerosis, 161, moderate Parkinsonian dysarthria, 96, with multiple sclerosis, x, , CD with Parkinson plus syndromes, 86 with Parkinson s disease, x, , CD phonation and, 87, rate of progression of, in Parkinson s disease, rate of speech changes in ALS, 20, respiration and, scanning speech, 156 severe dysarthria with Huntington s disease, 129, severe dysarthria with multiple sclerosis, 161, severe Parkinsonian dysarthria, 96, spasticity and, , 162 speech intelligibility related to other variables in ALS, 20, speech rate and, 87, 88 stages of, velopharyngeal function and, 87, 88 Speech-generating devices, 102 Speech intelligibility, 225 Speech language pathologists (SLPs), Speech production. See also Speech disorders (dysarthria) articulation and, 87, 88 components of, in Parkinson s disease, handout, CD normal speech processes with amyotrophic lateral sclerosis (ALS), normal speech production, CD phonation and, 87, respiration and, 86 87, 97 speech rate, 87, 88 structures for, CD velopharyngeal function and, 87, 88 Speech rate with Parkinson s disease, 87, 88 Speech treatment. See also Augmentative communication system (AAC) alphabet boards and alphabet board supplementation, 37, 102, , 163, 221 for amyotrophic lateral sclerosis (ALS), 29 41, CD behavioral intervention for, behavioral modifications and, 31, behavioral rate-control techniques, calendars and memory aids, 132, 154 communication for patients on ventilators, 41 conversation starters, delayed auditory feedback (DAF), 101 for detectable speech disturbance, 31, eye-gaze systems, 41 for Huntington s disease, , CD Lee Silverman Voice Treatment (LSVT), 80, loss of useful speech and, 41 making choices, 132 for mild dysarthria and cognitive change with Huntington s disease, for mild dysarthria with multiple sclerosis, for mild Parkinsonian dysarthria, for moderate dysarthria and cognitive change with Huntington s disease, for moderate dysarthria with multiple sclerosis, 161, for moderate Parkinsonian dysarthria, 96, for multiple sclerosis, , CD natural speech with supportive partners, 131

15 normal speech processes and, paced speech, pacing board, 102 for Parkinson s disease, 81, , CD principles for intervention, respiratory pattern stabilization program, 162 respiratory patterning, 163 for severe dysarthria with Huntington s disease, 129, for severe dysarthria with multiple sclerosis, 161, for severe Parkinsonian dysarthria, 96, speech-generating devices, 102 staging of intervention, theater voice, 100 visual-motor problems with multiple sclerosis, vocabulary selection and, 164 voice amplifiers, 101 yes/no systems, 41, , 139 Spinemet, 225 Spinobulbar muscular atrophy (Kennedy disease), 1, 2 Spirantization, 225 Sternocleidomastoid/trapezius muscles, Steroids, 152 Strained-strangled voice, 225 Striatonigral degeneration (SND), 74 Subchoreatic state of Huntington s disease, 122 Substantia nigra, CD Surgery. See also Tube feeding for aspiration management, for Parkinson s disease, 79 80, 91 for saliva management, 52 for speech disorders with Parkinson s disease, 91 for swallowing disorders with ALS, 52, Sustained phonation, 160 Swallow apnea, 43 Swallowing. See also Speech and swallowing examination; Swallowing disorders; Swallowing disorders management correct and incorrect positions for, 46, CD double swallow, 46 neck flexion position for, 46 normal swallowing, CD stages of, 225, CD Swallowing disorders (dysphagia). See also Speech and swallowing examination; Swallowing disorders management with amyotrophic lateral sclerosis (ALS), x, 42 54, CD assessment of, in clinical examination, 183, , assessment of, with ALS Severity Scale, 26 27, 42, 43 44, 56 assessment of, with Huntington s disease, assessment of, with Parkinson s disease, definition, 222 early eating problems and, 45, esophageal stage difficulties, 136, 137, CD handouts, CD with Huntington s disease, x, , CD interview worksheet for assessment of, 191 with multiple sclerosis, x, , CD oral preparatory and oral stage difficulties, 136, 137, CD with Parkinson s disease, x, 81, , CD 241

16 242 pharyngeal stage difficulties, 136, 137, CD with progressive supranuclear palsy (PSP), rate of progression of, in ALS, respiratory problems and, Severity Rating Scale for, 107, 108 slowed eating due to, CD stages of, swallow apnea, 43 symptoms of, with Parkinson s disease, warning signs of, 184, CD Swallowing disorders management for amyotrophic lateral sclerosis (ALS), aspiration management, assistive devices for, 138 compensation strategies, 109, CD dietary changes for, 27, 47 48, 109, 138, CD double swallow, 46 for Huntington s disease, liquid intake, 46, medications, for multiple sclerosis, normal eating habits, 45 NPO (nothing by mouth), 27, 49 for Parkinson s disease, postural and positional changes for, saliva management, 49 52, CD staging of intervention, supervision to control eating rate and bite size for, 138 tube feeding, Tasmar, 79 Telephone communication, 37 Thalamotomy, 79, 91 Theater voice, 100 TIV. See Tracheostomy invasive ventilation (TIV) Tolcapone, 79 Tongue, , 186 Tracheal diversion, 54 Tracheoesophageal anastomosis, 17 Tracheostomy, 225 Tracheostomy invasive ventilation (TIV), 16 Treatment. See Medications; Speech treatment; Surgery Tremor definition, 225 intention tremor in multiple sclerosis, 147, 153, 155 Parkinson s disease and, resting tremor, CD Trihexyphenidyl, 79 Tube feeding ALS Severity Scale and, 27 definition of nasogastric tube, 27, 224 intervention strategies, 48 management of, 49 PEG (percutaneous endoscopic gastrostomy) for, 14, 44, 48, 109, 224 symptoms indicating need for, 48 timing of, Tysabri, 152

17 Unified Parkinson s Disease Rating Scale (UPDRS), 76, 77 University of Nebraska AAC Center, 38 UPDRS. See Unified Parkinson s Disease Rating Scale (UPDRS) Upper extremity function assessment of, with ALS Severity Scale, 27 29, 58 definition, 225 Upper motor neurons, 225, CD 243 Velopharyngeal function, with Parkinson s disease, 87, 88 Velopharyngeal mechanism, definition, 225 Ventilators, 41, 225 Ventilatory assistance, Video recording of conversation, 199, , Vital capacity, 182, 225 Vocabulary selection, 164 Vocal fold closure, 54 Vocal folds, Voice amplifiers, 101 Weakness in amyotrophic lateral sclerosis (ALS), 3, 7, 8 definition of, 225 in multiple sclerosis, 147, 153, 155 Web sites, CD Westphal s variant of Huntington s disease, 122 WHO. See World Health Organization (WHO) Workplace. See Employment World Federation of Neurology Research Group on Neuromuscular Disease, 5 World Health Organization (WHO), 130 Yes/no systems, 41, , 139